Provider Demographics
NPI:1033083985
Name:BUTLER, ZACHARIAH GRANT
Entity type:Individual
Prefix:
First Name:ZACHARIAH
Middle Name:GRANT
Last Name:BUTLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 DEKALB PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1258
Mailing Address - Country:US
Mailing Address - Phone:610-270-0300
Mailing Address - Fax:
Practice Address - Street 1:686 DEKALB PIKE STE 101
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1258
Practice Address - Country:US
Practice Address - Phone:610-270-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist